Discover more common practices that persist in the hospital wards despite no proven benefit! We review how hospitals prescribe a “crapload” of docusate which only clogs up the medication list, how unnecessary echocardiograms are ordered enough times to make your head spin, and how basal insulin needs to slide back into your inpatient diabetes management instead of correctional insulin monotherapy. Join high-value care specialist Dr. Lenny Feldman (@DocLennyF, Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 2 of “Things We Do For No Reason™.”  SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose. Full show notes at https://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and Produced by: Justin Berk, MD MPH MBA, Matthew Watto MD Infographic: Justin Berk MD MPH MBA Cover Art: Matthew Watto MD Hosts: Stuart Brigham MD, Matthew Watto MD, and Paul Williams MD   Editor: Matthew Watto MD, Emi Okamoto MD Guest: Lenny Feldman MD, Tony Breu MD   Sponsor The Society of Hospital Medicine / Journal of Hospital Medicine - Things We Do For No Reason™series. Check out all the Things We Do For No ReasonTM articles here: Master Index of TWDFNR articles . Time Stamps 00:00 CME-MOC announcement https://www.shmlearningportal.org/curbsiders  00:50 Intro, disclaimer, guest bios 05:20 Guest one-liners, picks of the week 14:32 Things We Do for No ReasonTM (TWDFNR) defined 18:06 A case of syncope; definition 19:58 Do all patients with syncope need an echo? 23:30 What’s the diagnostic yield of echo for syncope? 29:36 Workup for new onset syncope 33:54 Aortic stenosis murmur 35:55 Docusate. Mechanism of action. Why is it so popular? What’s the harm? 42:08 Docusate. What does the evidence say? What should we use instead 50:05 A case of Sliding scale insulin (SSI); a brief history of insulin therapy and monitoring; SSI monotherapy: Risks, benefits, alternatives 59:30 Metformin in the hospital 65:35 Starting insulin in the hospital 68:20 Plugs- Things We Do For No ReasonTM. Become an author. 72:10 Outro and post-credits scene